Water Damage Claim Recovery — Westlake Village, CA
Settlement Results
Case Overview
A water loss caused extensive damage to a single-family rental property in Westlake Village. The water damage claim was initially denied after the insurance carrier classified the source of the water as groundwater.
Avner Gat Inc. became involved approximately two weeks after the loss. The first issue was whether the evidence supported the carrier's groundwater classification or pointed to a different cause of loss.
The claim also involved disputes over the repair scope for flooring extending through the staircase and second floor, loss of rental income, and other benefits available under the policy.
Key Claim Issues Addressed
The claim centered on several disputed conditions and repair-scope questions:
- Initial claim denial based on the carrier's groundwater classification
- Disagreement over whether the failed downstairs toilet was the actual cause of loss
- Disputed repair scope for matching flooring extending from the downstairs through the staircase and second floor
- Denied loss-of-rental-income benefits while repairs were underway
- Unresolved policy benefits beyond the initially approved repair scope
- Need for contents pack-out and temporary accommodations during construction
The Challenge: A Denied Water Damage Claim With Disputed Repair Scope and Rental Income
The insurance carrier initially classified the source of the water as groundwater and denied the claim. The carrier also limited the repair scope. It agreed to demolition and drying of portions of the downstairs flooring and walls but disputed work involving the staircase and second floor, even though the same flooring extended across all three areas.
The carrier also denied loss-of-rental-income benefits, maintaining that the property remained livable during construction.
The Solution: Expert Documentation, Repair Scope, and Policy Review
Kathy focused on three issues: establishing the cause of the water loss, documenting the flooring scope, and reviewing the policy for the denied rental-income claim and other available benefits.
Establishing the Covered Cause of Loss
Kathy recommended that the property owner bring in a second drying company to document where the water had traveled.
That company found evidence that the loss originated from a failed toilet in the downstairs bathroom. A licensed plumber then evaluated the plumbing failure and supported the finding that the toilet was the source of the water.
The drying documentation and plumber's findings were used to challenge the carrier's original groundwater classification. Approximately three months after the initial denial, coverage was restored.
Documenting the Full Repair Scope
Kathy worked with a licensed estimator hired by the property owner to prepare a detailed repair estimate. The estimate documented that the same flooring continued from the downstairs through the staircase and into the second floor, rather than ending at the areas the carrier had initially approved for demolition and drying.
Reviewing the Policy for Rental Income and Additional Benefits
Kathy reviewed the policy in connection with the denied loss-of-rental-income claim, including the carrier's position that the property could continue functioning as a rental during construction.
She also coordinated a licensed contents vendor to pack out the property and helped arrange temporary accommodations while repairs were underway.
The Outcome: From a Denied Claim to a $220,000 Recovery
After the original coverage denial was overturned, the remaining adjustment involved the disputed flooring scope and loss-of-rental-income claim.
The insurance company's initial offer was approximately $69,000. The final recovery reached $220,000, an additional $151,000 above that offer. The overall claim was resolved in approximately eight months.
Is Your Rental Property Water Damage Claim Denied or Underpaid?
A water damage claim can involve more than the areas initially approved for drying or repair. The cause of loss, matching materials, rental income, and other available policy benefits may all affect the final outcome of a claim.
If your insurer is disputing the cause of a water loss, limiting the repair scope, or denying rental income, Avner Gat Inc. Public Adjusters can review the carrier's position against the policy and the available damage documentation.
Contact Avner Gat Inc. Public Adjusters to discuss your water damage insurance claim.
